Working to make hockey safer for kids


In his teenage years, Patrick Lalor was a hockey player who dished out hits and took them as well - a guy known for doing time in the penalty box.

Or, as he likes to put it, "I was a goon."

But during one game, an opponent skated up from behind and struck Lalor across the back with his stick. Lalor spun around, hit the boards and collapsed.

"They had to carry me off the ice," he remembers. His opponent landed in the penalty box. But two days later, Lalor landed in a doctor's office with a pulled muscle and back pain.

Now 25, Lalor teaches aspiring hockey players to rely on finesse instead of unfocused fury. Even so, he bluntly points to the raw truth: "You don't get off the ice after a hockey game feeling like a million bucks. I don't know anybody who plays hockey who doesn't have bumps and bruises."

While the rest of the world turns to swimming, soccer, tennis, baseball and other hot weather sports, summer is also a busy time for ice hockey leagues. These days, instructors, coaches and medical experts alike are working to make safe the sport legendary for its bumps and bruises - not to mention brawls.

They believe it's important to start young because most hockey players are children or adolescents. In 2004, USA Hockey, the national governing body for the sport, reported some 535,000 registered members, including 373,644 youth members.

Likewise, of the 32,750 patients treated in emergency rooms for hockey-related injuries during 2001-2002, about 18,000 were under 18, according to a study reported in the medical journal Pediatrics.

"We do this kind of injury risk study to find patterns of injury, not because we want to discourage people," says Dr. Huiyun Xiang, a physician and investigator with the Center for Injury Research and Policy at the Columbus Children's Research Institute in Ohio. The aim is to promote safe, healthy play, he said.

Below the often dysfunctional world of professional hockey and its lockouts, the game at heart is a community sport that's gaining popularity here. USA Hockey reported a total overall membership in Maryland of 7,010 in 2004, an increase of 37 percent since 2000. In the Baltimore area alone, the organization claims about 4,700 players.

With ice time precious, players sometimes practice before sunrise or well after sunset. That makes for a devout group. "I've been skating since I could walk. Both my parents were figure skaters," Lalor explains. "I tried other sports: baseball, soccer. I couldn't get into it. There's something about hockey."

Ask players why they like it, and words like "intensity" and "exhilaration" pepper the conversation.

'Aggressive game'

"It's an aggressive game," observes Mike Shramek, coaching director for the Baltimore Youth Hockey club and head coach for Calvert Hall College High School. "One of the biggest things is just to teach respect for the opponent, respect for the game, respect for yourself."

A coaching philosophy that emphasizes hockey skills and enforcement of the rules is a key part of keeping players out of the emergency room, veterans say.

Injuries "may not be associated directly with player position, but rather are influenced by the player's perception of their role on the team," Michael J. Stuart, chief medical officer for USA Hockey, writes in a report on the organization's Web site. "The more aggressive, physical player who seeks out frequent contact may be at increased risk."

Researchers believe that checking (a form of contact that looks like pushing and shoving to the rest of us) is a common source of injuries. But checking is also part of the sport. From the time players reach 11 - the age at which they learn to give and take checks - the number of per-game injuries increases.

In Lalor's teenage years, some coaches wanted him to play rough, he says. The tactic worked until his team squared off against a bunch of better skaters from Nova Scotia. The result wasn't pretty.

He remembers thinking: "Those guys are skating circles around us. We can't even hit them. And then when they get their sights on us, they nail us." The epiphany transformed him.

Skating also presents a physical challenge upfront. "Hockey is one of the only sports where you have to learn to do something that's not natural before you learn to play: You have to learn to skate," says Bud Buonato, president of the Howard County Youth Hockey Club and a coaching education coordinator in Maryland.

In games with all-girl teams or younger children there's no checking. But that doesn't stop the occasional icy crash and clumping up of 8-year-old bodies.

"When you watch a videotape of a game, you say, 'Wow, that was unbelievable,' " says Buonato. He doesn't think it's any worse than his own days playing high school football. "My parents probably did the same thing. As a player, you can't go out there thinking, 'I don't want to get injured.' If you're too cautious, you get injured."

One coach called it "turtling up." Instinctively, a young player ducks his or her head. But coaches lecture young players about holding their heads up and keeping mouthpieces in place - two moves aimed at preventing concussion. The "heads up" message is important because if a player is pushed into the wall and hits the top of his head, neck or head injury is possible.

Bud Michels, coaching education director for Howard County Youth Hockey Club, recalls one game in which a tiny 9-year-old - looking downward at the time - collided with a larger player. "He ran right into his [teammate's] butt - that's how small this kid was. It wasn't that he got pushed into the kid, he just had his head down."

The boy suffered a concussion and sat out two weeks. "He kept his head up after that," Michels remembers.

Players devoted

Both players and coaches say padding and helmets are becoming more sophisticated. Face guards that are part of helmets for youth players have significantly reduced facial injuries.

Even so, players do suffer injuries - and some put off treatment. That's a problem, according to Dr. John Collins, who works in a sports medicine practice in Clarksville.

"The testosterone is pumping. It's part of the team sport. Nobody wants to be the guy who comes out of the game," he says. "With an injury, the body is going to respond with an inflammatory reaction. There's a risk for swelling. Anything you can do to minimize that early on will help the recovery."

Hockey has always been part of life for Alex Mitchell, a former Howard County youth league player. When he turned 12, he and teammates were in a breakaway - skating all out for the goal. Suddenly, Mitchell collapsed.

"I pulled the groin muscle ... away from the pelvic bone," he says. "It chipped the pelvic bone."

Mitchell sat out the rest of the regular season. Then the playoffs beckoned, and he felt good enough to return. "Five minutes into the game, I did it again," he remembers.

When he was 16, there was another problem: his back. "I ruptured a disc," he says. He's not sure when it happened. "Basically it was the wear and tear."

He tried acupuncture, physical therapy, electrical stimulation. Recently, he played for the first time in two years. "By the end of the game, my back was really aching," he says.

Now 20 and a rising junior at Towson University, he's tackled a different, if honorable, role in hockey.

He's a fan.

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